headaches, difficulty walking or speaking, dizziness,
vomiting. It is important to remember that most headaches
are due to less serious conditions.
5yo female, tired and moody, losing weight. normal exam,
normal blood and urine tests. 10 days later, "she started
holding her arm against her side and dragging her leg."
went to emergency room. "by that time she could not walk
without falling." "the MRI went well" but "when we walked in
there were seven doctors sitting around the table
who looked like they were terrified to be there."
The delay in the diagnosis of pediatric brain tumors
is certainly multifactorial. Infants and young children might
not be able to voice complaints.
5yo male, clumsy and falling down a lot, prescribed
glasses for farsightedness. three months later, the
left eye would no longer move from side to side.
MRI showed a large brainstem tumor, inoperable and impossible
to biopsy. "earned his angel wings" the following year.
8yo male, seeing double. multiple ophthalmologists.
negative exams, labs, and CTs. MRI: brainstem glioma.
6yo female, fell down and hit her head on the monkey bars,
got a headache and threw up - for several months.
"diffuse and infiltrative" brain tumor.
6yo male, fell off the monkey bars and broke his arm;
two weeks later started having headaches. medulloblastoma.
13yo male diagnosed with oligodendroglioma
"after weeks of persistent hiccups."
The lack of specificity of the most commons signs
and symptoms (such as headaches and vomiting), which may
mimic other more common diagnoses, often contribute to delays
in the diagnosis of brain tumors in this age group.
12yo male with a headache. family doctor said fluid
had built up in his ears and sinuses and gave him
antibiotics. the following day, he felt dizzy and had
double vision and slurred speech. doctor said not to stop
taking the antibiotic but to call again if concerned.
emergency room MRI: pontine brainstem glioma.
15yo female, vomiting in the mornings. negative
pregnancy test. diagnosis: sinusitis. the following week,
crashed her snowboard into a tree and walked away
staggering. medulloblastoma. "i wasn't frightened at first.
i was furious."
11yo female, needed glasses, sometimes clumsy.
during vacation, nausea and vomiting - on and off
for two weeks - always "having a good day" when visiting
the pediatrician - normal exams and labs. then - severe
headaches - "couldn't eat or get out of bed." MRI:
"the doctors were astonished that she hadn't had seizures
due to the tumor's size and location. they told us we
were lucky."
Contrary to expectations, the introduction of
modern imaging techniques has not influenced the delay
between the first symptoms and the diagnosis. However,
once the diagnosis is suspected, modern imaging techniques
undoubtedly facilitate the diagnostic process.
7yo male, no symptoms until "a funny turn at school...
barely conscious when the ambulance arrived." diagnosis:
migraine. next few weeks, problems with reading and memory.
headaches on and off, then a seizure. "we were surprised
and distressed to learn how aggressive this type of tumor is."
18 month old female, no symptoms. pediatric exam
suspected "lazy eye." MRI: large brain mass, "drop mets"
"like a sugar coating" down the spinal cord. first diagnosis:
medulloblastoma. second diagnosis: highly invasive rhabdoid tumor.
10yo male, "misdiagnosed for 7 years
with tourette's syndrome and laughing seizures,
until an MRI identified a hypothalamic hamartoma."
Recent reports have drawn attention to the importance
of behavioral symptoms, which account for up to one-fifth
of initial symptoms in children.
7yo female, "suddenly not as lively." lost her appetite.
fell asleep during class. one month later, stopped eating
and drinking. "instinct told us something was wrong."
high-grade glioma.
5yo female. ependymoma. "it's pretty rare. your odds
of winning the lottery are better."
4 month old male with unusual facial expressions
and eyerolling. pediatrician stated the baby "was just
trying out new faces and had gas." put on antacid.
emergency-room MRI: cerebellar ganglioglioma.
Increasing awareness of the issues associated with the
diagnosis of brain tumors in children among community
healthcare professionals may contribute to limiting delays
in diagnosis. However, whether this may translate into
improved outcome is still unknown.
december: born 7 lb 14 oz.
january: diagnosed with brain tumor, 3 x 2 x 1 cm.
february: tumor 6 x 4 x 5 cm.
march: 3rd course of chemotherapy.
april: 5 x 6 x 7 cm.
june: "she's an angel now looking down
on all of us with love."
between 2000 and 3000 children a year
are struck with brain tumors.
"It's a Tragedy and I can not find any reason
or purpose to why a child should have to die.
The feeling of Pain which is left behind is Immense."
i'm just saying.
